PSA testing for early detection of prostate cancer has been used by the insurance industry for years and is now a routine part of general medical and physical exams in men. It is proving to be a valuable resource in both instances.

PSA testing was first introduced in 1987, and resulted in an enormous increase in the reported incidence of reported prostate cancer in the United States. Early detection and aggressive treatment in the United States has led to a shift toward the identification of diagnosis.

PSA is a glycoprotein made almost exclusively by the outer epithelial layers of the prostate gland. Men with prostatic diseases, including prostate cancer, have high PSA levels because of increased production of the protein and an increased ability for it to penetrate into the circulation. There are other noncancerous causes for increased PSA.

Urologists look not only at the total PSA but at the pattern involved in its rise and a fraction called Free PSA. Studies have determined that the rate of increase of PSA percentage-wise may be more important than the absolute value itself. In other words, an increase in PSA from 2 to 4 may have more ominous consequences than one that bounces around from 7 to 9 on an intermittent basis. A usual upper limit for a PSA value is 4.0, but this does rule out cancer in some cases (where PSA levels may have risen from 1 to 3 for example) and is somewhat age dependent. This range extends in men who are over the age of 70.

Free PSA levels that are high have favorable prognostic implications. An increased PSA where the free percentage is high has less implication for cancer than one that may be mid-range but where the free percentage is quite low. These tests, along with a thorough evaluation and examination by a Urologist, lead to either watchful waiting or biopsy of the gland to diagnose cancer. Insurance companies may ask for a Urology evaluation of significantly high results before assessing a risk. This has actually lead to an increase in cases placed, as PSA levels that may have resulted in decline may be accepted with favorable results of this additional evaluation.

The information contained on this page is not intended to provide medical advice, which should be obtained directly from your physician.